Modified posterior scleral reinforcement for the treatment of traction maculopathy in myopia

Objective To evaluate the clinical effect and safety of modified posterior scleral reinforcement for the treatment of traction maculopathy in myopia. Methods This retrospective study included 30 patients (52 eyes) who were diagnosed with traction maculopathy in myopia. Fourteen cases (26 eyes) of macular foveoschisis (MF), 11 cases (19 eyes) of macular detachment (MD), and 5 cases (7 eyes) of macular hole with macular detachment (MHMD) were included in the study. All patients underwent modified scleral reinforcement combined with anterior chamber paracentesis. Best corrected visual acuity (BCVA) and axial length before and after the operation were compared by paired t-tests. Results The preoperative and 3 months postoperative BCVAs in the MF group (0.82±0.15 vs. 0.58±0.24, t=7.552, P<0.001), the MD group (1.06±0.17 vs. 0.71±0.27, t=7.120, P<0.001), and the MHMD group (1.78±0.22 vs. 0.91±0.21, t=17.571, P<0.001) each improved significantly. The axial lengths shortened from 29.59±1.57 mm to 27.60±1.35 mm of all the patients (t=22.880, P<0.001). Macular holes closed in 4 eyes in the MHMD group. The retina reattached in all eyes in the MD group and in 21 eyes in the MF group. The remaining 5 eyes in the MF group had an improved retinal appearance. Postoperative complications included pain, conjunctival injury, visual distortion, and a worsening visual distortion. Conclusion Modified posterior scleral reinforcement is an effective and safe way to treat traction maculopathy in myopia. It can be considered as the first choice in the clinic. Key words: Posterior scleral reinforcement; Macular splitting; Macular hole; Traction macular degeneration